Roots 45

NPI #1235725516 in Gaylord, Michigan

Provider Information

NPI Number: 1235725516
Entity Type: Organization
Organization Name: Roots 45
Primary Specialty: Clinic/Center - Mental Health (Including Community Mental Health Center)
Enumeration Date: Dec 21, 2020
Last Updated: Dec 21, 2020

Practice Location

Address: 100 W 1ST ST
City: Gaylord
State: Michigan
ZIP Code: 49735-1355
Phone: (989) 350-3053

Authorized Official

Name: JENNIFER ELLEN WUMMEL, LMSW
Title: BH THERAPIST
Phone: (989) 350-3053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Mental Health (Including Community Mental Health Center) — Mental Health (Including Community Mental Health Center)	261QM0801X	Primary

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